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THE HAGUE The upper house of the Dutch parliament approved a euthanasia bill yesterday, making the Netherlands the first country to allow doctors to end the lives of patients suffering unbearably and without hope.

About 10,000 pro-life protesters surrounded the parliament building, praying, singing hymns and quoting the Bible. Inside, the Dutch Senate voted 46-28 in favor of the legislation.

Before the Senate vote, Health Minister Els Borst gave a final assurance that the law could not be abused by doctors because of careful supervisory provisions. The law presupposes a long doctor-patient relationship, and excludes the possibility of euthanasia for nonresidents of the Netherlands.

The law, likely to take effect this summer, formalizes guidelines adopted in 1993 under which doctors have been assisting suicides with tacit approval, said Justice Minister Benk Korthals.

"This law will remove the uncertainty for patients and for doctors," the health minister told senators.

Outside the parliament building, activists wore black ski masks and carried oversized syringes dripping with blood-red liquid. Several Christian schools canceled classes to allow students from across the country to participate in the demonstrations.

"We don't have the right to decide about matters of life and death, but God does," said 19-year-old Henrico van der Hoek as he walked passed Parliament. "As Christians, we simply cannot support this law."

Arguing for the bill, government ministers cited public approval ratings of nearly 90 percent.

In the weeks preceding the debate, the upper house was swamped with more than 60,000 letters, most of them urging the legislators to vote against the bill. The anti-euthanasia group "Cry for Life" gathered 25,000 signatures on a petition.

After 30 years of public debate on mercy killings, the lower house passed the bill in November by a vote of 104-40. Its progress has been closely watched in Europe and the United States.

German Justice Minister Hertha Daeubler-Gmelin criticized the Dutch legislation, and said on ARD television that the emphasis should remain on therapy to reduce suffering.

The Vatican strongly denounced the bill after it was passed by the lower house last year.

Egbert Schuurman of the Netherlands' conservative Christian Union called the bill "a historic mistake." Being the first country to legislate euthanasia "is something to be ashamed of.

"Others may be proud, but we will expect that some may wonder later how could they have walked this path," he said.

Several countries Switzerland, Colombia and Belgium tolerate euthanasia, although it has not been legalized. In the United States, Oregon has allowed doctor-assisted suicide for the terminally ill since 1996, but its law is more restrictive than the Dutch bill. In Australia, the Northern Territories enacted a law in 1996, but it was revoked in 1997 by the federal Parliament.

Under the Dutch law, a patient has to be experiencing irremediable and unbearable suffering, be aware of all other medical options and have sought a second professional opinion. The request must be made voluntarily, persistently and independently while the patient is of sound mind. Doctors are not supposed to suggest it as an option.

The new law also allows patients to leave a written request for euthanasia, giving doctors the right to use their own discretion when patients become too physically or mentally ill to decide for themselves.